Turf Toe Explained

If you could look at what goes on inside your feet when you walk, run, or jump, you’d be amazed at the complexity. The joint between your first metatarsal and great toe, for example, is an engineering marvel, but it is also quite susceptible to damage with certain activities. Turf toe – a sprain of the tissues around that joint – is a common problem.

Anatomy of the MTP joint

The metatarsophalangeal (MTP) joint is the connection between your first metatarsal and the big toe phalanx. The plantar plate (ligament) under the joint, the collateral ligaments on either side of it, and the flexor halluces brevis tendon between the metatarsal and the phalanx all work together to stabilize the MTP joint and allow you to push off for each step.

What Happens with Turf Toe

Many activities could cause this injury, such as an accident or a fall, but it happens most often to athletes in sports such as football, soccer, basketball, wrestling, gymnastics or dancing. Any time your foot is in contact with a hard surface that doesn’t give, such as artificial turf or hardwood flooring, you risk hyperextending the big toe. Cleats can dig into the turf and plant the toe on the ground. You could be tackled forward or push off for a step or jump, and your big toe is bent too far up toward the top of your foot, spraining the ligaments. A mild sprain could simply stretch them too far, while a more serious one may cause small tears in the tissue. In severe cases, a ligament could rupture completely. Men and women are equally susceptible to this injury.

What Turf Toe Feels Like

Pain is the first symptom, just as it is with a sprained ankle. The area at the base of the great toe can swell up and become stiff. The joint may feel weak, or you may not be able to move it normally. You could also see bruising from broken capillaries bleeding under the skin. It may make it harder to wear shoes, and you may not be able to walk on that foot without pain. You certainly won’t be able to do your normal sports activities, nor should you try until the injury has healed.

Treating a Sprained Toe

As with many other injuries, RICE therapy is the first treatment we advise:

  • Rest the toe by keeping weight off from it.
  • Use ice packs to treat pain and swelling (a bag or frozen peas wrapped in a thin cloth works well).
  • Compress the joint with an elastic wrap or taping to help keep the swelling down. We can show you how to do this without hampering your circulation.
  • Elevate the foot. Sit or lie down with your feet resting on pillows so they are above heart level. This keeps fluids from settling there, reducing swelling and pain.

We may also recommend the proper anti-inflammatory medication for your situation. If the sprain is very severe, we may have you wear a walking boot or apply a cast to keep the joint immobile and protected while you heal.

Follow Up Turf Toe Care

After the symptoms have settled down, we may order 4 – 6 weeks of physical therapy. This is important to return range of motion to the MTP joint and strengthen the ligaments, tendons and muscles so you do not reinjure it. Proper healing decreases your risk of developing bunions, arthritis or chronic stiffness in the joint.

Prevent this injury in the first place by choosing the proper shoes for your activity and making sure your feet are in great shape for your sport or activity. Orthotics can also help by controlling the motion in your big toe. At Atlantic Foot & Ankle Associates, we can design a custom pair that addresses any biomechanical issues with your feet. Call one of our five east Florida offices and set up an appointment to protect your feet and enable you to enjoy your favorite activities safely. Call our Palm Coast office at (386) 586-7373, or check one of our other locations near you. You can also schedule online using our appointment request tab.